ArticleBiology of reproduction2021
The SARS-CoV-2 receptor, angiotensin-converting enzyme 2, is required for human endometrial stromal cell decidualization†.
Article in Biology of reproduction, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 4 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 4 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Long COVID and endometriosis: a systematic review and meta-analysis.BMC women's health · 2025Pooled it
- Impact of COVID-19 Vaccination onInternational journal of fertility & sterility · 2024Pooled it
- An understanding of coronavirus and exploring the molecular dynamics simulations to find promising candidates against the Mpro of nCoV to combat the COVID-19: A systematic review.Journal of infection and public health · 2022Pooled it
- Endometriosis and COVID-19: A Systematic Review and Meta-Analysis.International journal of molecular sciences · 2022Pooled it
- The Impact of Long COVID on the Female Reproductive System: A Narrative Review.International journal of molecular sciences · 2026Review
- COVID-19 and female reproductive health: pathophysiological mechanisms and clinical reproductive outcomes.Frontiers in medicine · 2026Review
- Impact of COVID-19 on live birth and perinatal outcomes following subsequent frozen-thawed embryo transfer.Journal of assisted reproduction and genetics · 2025Article
- Angiotensin‑converting enzyme 2 expression in human tumors: Implications for prognosis and therapy (Review).Oncology reports · 2025Review
- The association between pregnancy outcomes of frozen thawed embryo transfers and previous SARS-CoV-2 infections.Scientific reports · 2025Article
- Harnessing 2D and 3D human endometrial cell culture models to investigate SARS-CoV-2 infection in early pregnancy.Clinical science (London, England : 1979) · 2025Article
- Sex hormones in COVID-19 severity: The quest for evidence and influence mechanisms.Journal of cellular and molecular medicine · 2024Review
- SARS-CoV-2 infection is detrimental to pregnancy outcomes after embryo transfer in IVF/ICSI: a prospective cohort study.BMC medicine · 2024Article
- Effects of SARS-CoV-2 Vaccination on Menstrual Cycle: An Italian Survey-Based Study.Journal of clinical medicine · 2023Article
- Unexpected vaginal bleeding and COVID-19 vaccination in nonmenstruating women.Science advances · 2023Article
- Investigation of Coronavirus disease 2019 virus in vaginal fluid and menses blood and the effect on menstrual cycle duration and sexual desire: A cross-sectional study.International journal of reproductive biomedicine · 2023Article
- SARS-CoV-2 infection and female reproductive health: A narrative review.Best practice & research. Clinical endocrinology & metabolism · 2023Review
- COVID-19-The Shift of Homeostasis into Oncopathology or Chronic Fibrosis in Terms of Female Reproductive System Involvement.International journal of molecular sciences · 2023Review
- Effects of COVID-19 Infection and Vaccination on the Female Reproductive System: A Narrative ReviewBalkan medical journal · 2023Review
- "GONE WITH THE WIND": The Transitory Effects of COVID-19 on the Gynecological System.Journal of personalized medicine · 2023Review
- Unraveling the relationship between the renin-angiotensin system and endometrial cancer: a comprehensive review.Frontiers in oncology · 2023Review
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4 authors at 1 institution in 1 country.
Funding
Abstract
The coronavirus disease 2019 (COVID-19) first appeared in December 2019 and rapidly spread throughout the world. The SARS-CoV-2 virus enters the host cells by binding to the angiotensin-converting enzyme 2 (ACE2). Although much of the focus is on respiratory symptoms, recent reports suggest that SARS-CoV-2 can cause pregnancy complications such as pre-term birth and miscarriages; and women with COVID-19 have had maternal vascular malperfusion and decidual arteriopathy in their placentas. Here, we report that the ACE2 protein is expressed in both endometrial epithelial and stromal cells in the proliferative phase of the menstrual cycle, and the expression increases in stromal cells in the secretory phase. It was observed that the ACE2 mRNA and protein abundance increased during primary human endometrial stromal cell (HESC) decidualization. Furthermore, HESCs transfected with ACE2-targeting siRNA impaired the full decidualization response, as evidenced by a lack of morphology change and lower expression of the decidualization markers PRL and IGFBP1. Additionally, in mice during pregnancy, the ACE2 protein was expressed in the uterine epithelial cells, and stromal cells increased through day 6 of pregnancy. Finally, progesterone induced Ace2 mRNA expression in mouse uteri more than vehicle or estrogen. These data establish a role for ACE2 in endometrial physiology, suggesting that SARS-CoV-2 may be able to enter endometrial stromal cells and elicit pathological manifestations in women with COVID-19, including an increased risk of early pregnancy loss.
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